CT of hepatoma: effects of portal vein obstruction

CT images were studied in five patients with hepatocellular carcinoma associated with obstruction of branches of the portal vein. Two were solitary tumors located near the porta hepatis and were seen as low density areas. In addition noncancerous areas with impaired portal drainage also had lower densities than normally perfused areas. In one instance, gross and histologic studies performed on the resected specimen showed atrophy of hepatic tissue. The other three patients had disseminated tumors with multiple low density areas on CT. Additional low density areas were seen in patients with concomitant obstruction of branches of the portal vein. A decrease in portal blood flow will change the appearance of hepatocellular carcinoma of CT.